Provider Demographics
NPI:1639119357
Name:BRUNO-PADILLA, MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:BRUNO-PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARITA
Other - Middle Name:
Other - Last Name:BRUNO-PADILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:T2-2 CALLE IGUAZU
Mailing Address - Street 2:PARK GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2325
Mailing Address - Country:US
Mailing Address - Phone:787-306-3085
Mailing Address - Fax:
Practice Address - Street 1:AVE DOMENECH FINAL
Practice Address - Street 2:HOSPITAL DEL MAESTRO 2NDO PISO
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00936-4708
Practice Address - Country:US
Practice Address - Phone:787-763-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11447207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41265Medicare UPIN
PR0088570Medicare ID - Type UnspecifiedPROVIDER NUMBER